Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Anthony Dennison — Mon, 18 Jan 2021 10:22:43 GMT

I would consider chemotherapy for lymphoma, depending on the predominant cell line. This could be as simple as daily preds, or add in chlorambucil at 20mg/m^2 every 2 weeks, all the way up to a chop protocol.

Sarcoma I'm not too sure on I'm afraid, you'd have to consult with an oncologist. I dont think they're are responsive to chemo as other tumours

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Beats — Mon, 18 Jan 2021 08:14:25 GMT

Thanks Anthony, gut is well healed by this stage I would reckon.

Just to get things clear in my own head:

1) If IHC confirms is lymphoma, what would you recommend be done?

2) If IHC confirms is sarcoma, what would you recommend be done?

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Anthony Dennison — Sun, 17 Jan 2021 22:58:11 GMT

I agree with Sara. IHC would be very useful in this case to get a better differentiation as to what is going on. Is it a sarcoma? Is it a lymphoma with some sort of weird inflammatory reaction that is being confused as a sarcoma?

Hold off on chemo for now, as you don't really know what you're dealing with and the protocols for the 2 different neoplasms differ. Plus allows healing from the GI surgery.

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Sara Ramsey — Fri, 15 Jan 2021 20:40:02 GMT

gosh, I'm definitely not an oncologist but have done a few chemo cases.. the decision making is hard!

I wouldn't do chemo now. The diagnosis is not clear so it would be experimental, also the margins looks clear and the LN was also clear.... they mention spindle cells a lot which could be more supportive of a sarcoma with a surgical cure? I also wonder, if it was a lymphoma that had been there a while.. would it have already spread to the LN?

I think doing chemo on the grounds of the appearance of imaging alone would also be risky.

The cases I have done have mainly been "well" multicentric lymphomas .. where staging (sampling spleen and BM) wasn't considered as crucial as prognosis didn't differ. We did stage in a mammary carcinoma case.. LN were removed with mammary tissue.

It might be worth speaking to the lab about how much information an IHC will give you i.e. could it prove a sarcoma? I have requested it for lymphomas but not for sarcomas so I don't have much experience there.

If finances allow, I would do the IHC. It might not change the overall plan (given cat is elderly and well).. but it might make advising the client a bit easier, especially if they were very keen to send it off for histopath and would appreciate a more definitive answer rather than grey areas?

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Beats — Fri, 15 Jan 2021 19:58:02 GMT

Thanks Sara!

Am I right in saying that if sarcoma, then nothing else done, while if lymphoma then:

1) could consider some sort of chemo now? But cat doing well and gaining weight, so would have to be clear benefit to consider.

2) could consider imaging to see if other signs of lymphoma and then give chemo if there is? But again cat doing well and gaining weight.

3) could consider some sort of chemo in future should a palpable mass recur - the benefit being that one would know that it was lymphoma and therefore may respond to medical treatment should it become ill again?

I'm guessing (3) is maybe the most reasoned argument for wishing to know if a resected jejunal mass is a cat is lymphoma vs sarcoma? But I'm still a bit unsure.

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Sara Ramsey — Fri, 15 Jan 2021 18:50:36 GMT

I may be wrong but a sarcoma could potentially be fully resected as they tend to be locally invasive rather than metastatic. With a lymphoma, it's more likely to be a systemic cancer and curative surgery is less commonly achieved.

if owner doesn't want to pay for IHC and wouldn't consider staging and chemo then it probably doesn't matter so much...a 13 year old mainecoon getting through an enterectomy is great, hope it does ok.

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Beats — Tue, 12 Jan 2021 07:44:59 GMT

It might not have been very well preserved might be part of issue...

RE: Cat Intestinal mass - Lymphoma vs Sarcoma - does it matter?

Julie Turner — Mon, 11 Jan 2021 21:51:21 GMT

This sounds a bit odd Beata - a localised spindle cell tumour condoned to the intestine vs a report veering towards lymphoma. Abs the cat recovering well.
perhaps ask for a second opinion on the histopathology.
I am not an oncologist, so perhaps seek third opinion too